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Osteoporosis prior to surgery may not affect outcomes of proximal humerus fractures

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Osteoporosis prior to surgery may not affect outcomes of proximal humerus fractures


October 06, 2022

1 min read

Source/Disclosures

Disclosures:
The authors report no relevant financial disclosures.


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Results showed preoperative osteoporosis and loss of bone mineral density after surgery did not affect failure risk or functional outcomes after open reduction and internal fixation of three- or four-part proximal humerus fractures.

“Osteoporosis may not be regarded as a contraindication for treatment of displaced three- or four-part fractures with [open reduction and internal fixation] ORIF,” the authors wrote.

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Researchers collected preoperative, 6-week and 3-, 6- and 12-month postoperative radiographs and DXA scans in four templated regions of interest among 36 patients who underwent ORIF for unilateral displaced three- or four-part proximal humerus fractures. Researchers also assessed functional outcomes using the Western Ontario Osteoarthritis of the Shoulder (WOOS) index, Constant score, VAS pain scale and SF-36 questionnaire.

Researchers found 17 of 36 patients had osteoporosis. Results showed patients in the osteoporosis group and non-osteoporosis group had no differences in bone mineral density (BMD) changes, functional outcomes, radiology or need for revision surgery. In all four regions of interest, researchers noted a gradual decline of BMD values in the operated shoulders from baseline to 3-month follow-up. Although healthy shoulders had no significant BMD changes during the study, results showed a reduction in BMD in all four regions of interest in the operated shoulder at 3, 6 and 12 months compared with baseline. Researchers found an increase in the Constant score from 3 to 12 months but a decrease in physical function, general health and bodily pain domains of the SF-36 from preinjury to 12-month follow-up. Researchers noted comparable WOOS index and VAS pain at rest and activity preinjury and at 12-month follow-up.